Respiratory consultation fees revealed


By Geir O'Rourke

16 Sep 2023

Respiratory physicians are charging significantly less than most other ‘office-based’ specialties in private settings and bulk-billing almost a third of all consultations, new figures show.

The data come from the federal government’s troubled Medical Costs Finder website, which is now accepting fee information from individual doctors, including sleep and respiratory physicians, after a $17 million relaunch last December.

The Department of Health says respiratory specialists can register their interest and will soon be able to input their fees for initial and follow-up consultations.

Other specialists, such as cardiologists and gastroenterologists, can share their fees charged for procedures such as colonoscopy, coronary angiography, heart catheterisation and stent insertion.

So far, few specialists have taken up the offer, with the site displaying the individual details of just half a dozen doctors around the country when the limbic checked last week.

But the site is now displaying updated aggregate Medicare data, revealing 32% of initial respiratory and sleep medicine appointments were bulk-billed in 2021-22.

Of the 68% of initial consults to which a gap fee was applied, patients were charged $260 on average, coming out as $125 after the Medicare rebate.

By contrast, 26% of initial rheumatology appointments claimed under MBS item 110 were bulk-billed, leaving the rest with an average out-of-pocket cost of $155.

Oncologists were the specialists most likely to bulk-bill, with 75% of their initial consults having no out-of-pocket costs.

The site also shows there were wide variations in the fees charged by respiratory physicians, with the top 10% most expensive initial consults having out-of-pocket costs of at least $205 versus $55 for the bottom decile.

There was also significant regional variance when it came to sleep and respiratory medicine fees.

Initial attendances (MBS item 110)

% with no out-of-pocket costs 30% 28% 40% 27% 24% 23%
Typical specialists’ fees $280 $240 $265 $250 $300 $285
Patients typically paid $117 $105 $130 $115 $165 $150

Respiratory physicians’ subsequent consultations showed similar patterns, with 34% bulk-billed and the rest having a $70 median out-of-pocket cost (after $68 Medicare rebate)

Bulk-billing rates for these consultations ranged from 45% in NSW to just 25% in Queensland.

Endocrinologists in Queensland also charged the highest fees at $150 on average, according to the figures.

Subsequent attendances (MBS item 116)

% with no out-of-pocket costs 25% 29% 34% 26% 37% 45%
Typical specialists’ fees $150 $130 $128 $142 $125 $150
Patients typically paid $82 $62 $60 $74 $57 $78

The updated site also includes detailed fee information for about 100 procedural items covered by Medicare, including the typical private hospital fees and those covering specialists, anaesthetists and assistant surgeons.

For example, the site shows that for heart angiogram with or without catheterisation (MBS items 38252 and 38218), 16% of privately insured patients had an out-of-pocket cost.

For this procedure, Medicare paid $1000 on average and health funds paid $800, according to the site.

In addition, it says the hospital fees for this procedure were typically $4,200, covered mostly by health funds depending on a patient’s level of insurance.

At a webinar earlier this year, officials stressed they were still hoping to expand participation of individual specialists in the site, arguing recruitment was expected to build with additional exposure.

They also argued there was significant interest from the public, claiming the database was already receiving about 6,000 hits per month.

MBS item 110 (rebate $135): initial consult

Specialty Bulk-billing rate Average out of pocket cost Highest 10% of fees were at least* Bottom 10% of fees were under*
Gastroenterology 33% $115 $185 $45
Cardiology 42% $110 $186 $45
Endocrinology 32% $125 $215 $65
Neurology 34% $195 $270 $90
Rheumatology 26% $155 $255 $75
Oncology 75% $145 $255 $55
Haematology 52% $115 $185 $60
Respiratory 32% $125 $205 $55

*after Medicare rebate

MBS item 116 (rebate $68): follow-up consult

Specialty Bulk-billing rate Average out of pocket cost Highest 10% of fees were at least* Bottom 10% of fees were under*
Gastroenterology 37% $62 $107 $27
Cardiology 41% $70 $117 $32
Endocrinology 32% $82 $142 $42
Neurology 33% $102 $162 $52
Rheumatology 32% $82 $112 $47
Oncology 68% $67 $102 $35
Haematology 63% $57 $87 $27
Respiratory 34% $70 $112 $32

*after Medicare rebate


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